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Patient handout

Colorectal cancer (core)

PRODUCTION

1. Your condition

This handout is for colorectal cancer (core). Your care team identified this based on: positive fit or stool-dna test on screening (uspstf 2021).

Other reasons your team may use this plan: polyp/mass identified at colonoscopy requiring biopsy or referral (usmstf 2020); rectal bleeding, occult-blood-positive anemia, or change in bowel habit (nccn colon/rectal 2026); biopsy-confirmed colorectal adenocarcinoma (nccn colon/rectal 2026).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

MedicationStarting doseHowWhenWhat it does
fluorouracil400 mg/m2 bolus + 2400 mg/m2 over 46hIVq2w x 12 cycles (FOLFOX-6)MOSAIC + IDEA — FOLFOX backbone for high-risk stage III (T4 or N2) x 6 months
leucovorin400 mg/m2IVq2w with 5-FU5-FU modulator in FOLFOX
oxaliplatin85 mg/m2IVq2w x 12 cyclesOxaliplatin partner for high-risk stage III; cumulative neurotoxicity monitor
capecitabine1000 mg/m2POBID days 1-14 q3w x 4 cycles (CAPOX 3 months)IDEA (Grothey NEJM 2018 PMID 29590544) — CAPOX 3 months non-inferior to 6 months in low-risk stage III

Plan: Adjuvant stage III colon — IDEA-driven FOLFOX/CAPOX duration

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

  • Obstructing or perforating CRC — closed-loop large-bowel obstruction, free air on imaging, faecal peritonitis(life-threatening)
  • Massive lower-GI bleed from CRC with hemodynamic instability or transfusion >4u(life-threatening)
  • Persistent grade 3 peripheral neuropathy interfering with ADLs
  • Grade >=3 irAE on ICI (especially dual nivo+ipi) — colitis, hepatitis, pneumonitis, myocarditis, severe endocrinopathy
  • Acute abdomen + free air on imaging in a patient on bevacizumab — GI perforation(life-threatening)

5. Follow-up

NCCN survivorship intervals; Lynch cascade-testing for family if MMR-deficient; high-risk syndrome surveillance (annual EGD/colonoscopy for FAP, gynae screening for Lynch); long-term oxaliplatin neuropathy management; bowel-habit + ostomy care (NCCN Colon/Rectal 2026)

6. Sources

Guideline: NCCN Colon 2026 + NCCN Rectal 2026 + USPSTF 2021 CRC screening + ASCO 2022 metastatic

  1. pubmed.ncbi.nlm.nih.gov/29590544
  2. pubmed.ncbi.nlm.nih.gov/31566309
  3. pubmed.ncbi.nlm.nih.gov/33264544